Gujarat's lag in under-5 nutrition: Economic progress alone can't reduce undernutrition

By Rajiv Shah
A high-profile study, “India Health Report: Nutrition 2015”, released last month, has found that “developed” Gujarat lags behind most major Indian states in child nutrition status. Quoting latest Government of India figures, the study says that 33.5 per cent of under-five children are underweight, which is the seventh worst among 20 major Indian states.
The study, which has been carried out by the Public Health Foundation of India, and jointly sponsored by Transform Nutrition and UK Aid, further says that 41.6 per cent under five children in Gujarat suffer from stunting, which is the fifth worst among 20 major states; and 18.7 per cent suffer from wasting gujarat(or low weight for height), which is the third worst among 20 major states.
Basing its analysis on the latest data (for 2014) provided by the Rapid Survey on Children (RSoC), Ministry of Women and Child Development, Government of India, the study’s example of Gujarat goes a long way to suggest that, to quote from the report, “economic growth cannot, by itself, reduce undernutrition.”
Pointing towards “massive variables across states”, which mask recent progress in overcoming the problem of undernutrition, the study reports, in India, “38.7 per cent children under five are stunted, 19.8 per cent are wasted, and 42.5 per cent are underweight.”

Giving the example of well-to-do states in this context, the study says, in Punjab, “which best represents the national average per capita income at Rs 49,529 (2013-14), the prevalence of stunting among children under five is 30.5 percent (lower than the national average of 39 percent).” And, interestingly, “although Tamil Nadu and Gujarat have similar levels of income, Tamil Nadu has a much lower stunting rate of 23.3 percent, while it is 41.8 percent in Gujarat.”
“These disparities”, the study says, “indicate that levels of income do not automatically translate to lower stunting, and warrants a closer look at other known developmental drivers of stunting.” It adds, “Most analyses of stunting declines confirm that economic progress alone is not sufficient to achieve significant nutritional gains.”
Thus, “from 1998–99 to 2005–2006, GDP per capita in India expanded by 40 percent in real terms. Despite the rising levels of prosperity and 18 reduced levels of poverty among millions of Indians, the proportion of stunted children under age three declined by only 6.1 percentage points in that seven-year period, from 51 to 44.9 percent.”
Citing a study of 63 countries, including India, the study says, it shows that “increases in per capita national income translated into improvements in child nutritional status only if the economic gains facilitated public and private investments that could improve conditions related to diet and disease.” 

The study says, India’s “child nutrition rates have been declining, first at a slow rate between 1992 and 2006, and at an accelerated rate since 2006.” However, it underlines, “these developments are below the rate needed to meet the World Health Assembly’s targets to which India is signatory to.”
“Between 2006 and 2014, India’s stunting rate of children below five years declined from 48 per cent to 39 per cent. This decline in stunting in India is translated to 14 million fewer children and decline in wasting is translated to seven million fewer wasted children. Despite this, child under-nutrition rates in India are among the highest in the world. India is still home to over 40 million stunted children and 17 million wasted children under five”, the study adds.
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Click HERE to download the study